Cardiovasc Imaging Asia.  2024 Jul;8(3):61-63. 10.22468/cvia.2024.00073.

Late Gadolinium Enhancement of the Anterolateral Papillary Muscle in a Patient With Acute Myocardial Infarction, Atrial Fibrillation and Hypertrophic Cardiomyopathy

• Cheow TY
• Yew MS

• KMID: 2558380
• DOI: http://doi.org/10.22468/cvia.2024.00073

Abstract

A 43-year-old male with no past medical history presented with acute onset palpitations, chest pain and diaphoresis. Electrocardiogram showed atrial fibrillation with rapid ventricular response. High-sensitivity cardiac troponin I was elevated at 87 ng/L at presentation and rose further to 1874 ng/L 8 hours later. Invasive coronary angiography revealed significant stenosis of the left circumflex artery, which was treated with percutaneous coronary intervention. Transthoracic echocardiography showed severe left ventricular hypertrophy with mild systolic anterior motion of the anterior mitral leaflet. Cardiac magnetic resonance demonstrated features consistent with hypertrophic cardiomyopathy with regional fibrosis. Of note, focal delayed enhancement was seen in the anterolateral papillary muscle.

Keyword

Hypertrophic cardiomyopathy; Myocardial infarction; Papillary muscles; Magnetic resonance imaging; Atrial fibrillation